American Journal of Drug and Alcohol Abuse最新文献

{"title":"Disentangling the effects of racism-related stress on opioid use disorder and chronic pain outcomes.","authors":"Julio C Nunes, Oluwole O Jegede, Joao P De Aquino","doi":"10.1080/00952990.2024.2369866","DOIUrl":"10.1080/00952990.2024.2369866","url":null,"abstract":"<p><p>In recent years, Black people in the U.S. have had one of the highest increases in opioid overdose mortality rates, despite being less likely to be prescribed opioids for pain. This population is also less likely to receive medications for opioid use disorder (MOUD). Chronic pain is a central factor in understanding this crisis, as minoritized people are more likely to live with undertreated pain, a major risk factor for developing opioid use disorder (OUD). Current practices fail to effectively treat pain among persons with OUD, a missed opportunity that is worse in minoritized populations and further producing disparities. In this perspective, we discuss how racism-related stress and disparities in addiction treatments may impact the pain experience, diagnosis, treatment, contribute to developing OUD, and perpetuate stigma. This high-level perspective invites clinicians and researchers to reflect on the biopsychosocial burden imposed upon historically minoritized people with pain and OUD. To address such complex issues, multidisciplinary efforts and methodological improvements are required, imbued by antiracist values. Collaboration across disciplines is necessary toward the common goal of improving pain management and mitigating opioid mortality among minoritized populations. As antiracist perspectives inform research practices and cultural humility principles guide care, we will be better equipped to close current gaps in knowledge and address widening healthcare disparities.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"455-461"},"PeriodicalIF":2.7,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying neurofunctional domains across substance use disorders.","authors":"Emily E Hartwell, Melanie Schwandt, Yaira Z Nunez, Reagan R Wetherill, Rachel L Kember, Corinde E Wiers, Joel Gelernter, Henry R Kranzler","doi":"10.1080/00952990.2024.2368180","DOIUrl":"10.1080/00952990.2024.2368180","url":null,"abstract":"<p><p><i>Background:</i> Substance use disorders (SUDs) are heterogeneous across multiple functional domains. Various frameworks posit that domains (e.g., executive function) contribute to the persistence of SUDs; however, the domains identified in different studies vary.<i>Objectives:</i> We used factor analysis to identify the underlying latent domains present in a large sample (<i>N</i> = 5,244, 55.8% male) with a variety of SUDs to yield findings more generalizable than studies with a narrower focus.<i>Method:</i> Participants (1,384 controls and 3,860 participants with one or more SUDs including alcohol, cocaine, cannabis, and/or opioid use disorders) completed the Semi-Structured Assessment for Drug Dependence and Alcoholism, the NEO Personality Inventory, and the Wisconsin Card Sorting Test. Exploratory factor analysis (EFA) and fit indices (root mean-squared error of approximation (RMSEA), Comparative Fit Index (CFI), and Tucker-Lewis Index (TLI)) were used to examine different latent variable models. A multiple indicators, multiple causes (MIMIC) approach-tested associations of the latent variables with sociodemographics, substance use, and a history of abuse/neglect.<i>Results:</i> A six-factor model (predominant alcohol, predominant cocaine, predominant opioid, externalizing, personality, and executive function) provided the best fit [RMSEA = 0.063 (90% CI 0.060, 0.066), CFI = 0.98, TLI = 0.96]. All factors were moderately correlated (coefficient = 0.25-0.55, <i>p</i> < .05) with the exception of executive function. MIMIC analysis revealed different patterns of associations (all <i>p</i> < .0001) with sociodemographics, substance use, and a history of abuse/neglect among the factors.<i>Conclusions:</i> The domains identified, particularly executive function, were parallel to those observed previously. These factors underscore the heterogeneous nature of SUDs and may be useful in developing more targeted clinical interventions.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"536-546"},"PeriodicalIF":2.7,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A proof-of-concept study testing the factor structure of the Stop Signal Task: overlap with substance use and mental health symptoms.","authors":"Jodi M Sutherland Charvis, Chrystal Vergara-Lopez, Evelyn M Hernandez Valencia, Mary Ellen Fernandez, William Rozum, Hector I Lopez-Vergara","doi":"10.1080/00952990.2024.2316599","DOIUrl":"10.1080/00952990.2024.2316599","url":null,"abstract":"<p><p><i>Background:</i> Research utilizing experimental tasks usually does not report estimates of internal reliability of measurement. However, modern measurement theories conceptualize reliability as sample dependent indicating that reliability should be empirically demonstrated in the samples used to make inferences.<i>Objectives:</i> Test whether confirmatory factor analytic (CFA) estimates of reliability can be applied to a commonly used task measuring response inhibition (the Stop Signal Task) to predict substance use (alcohol and cannabis) and mental health symptoms.<i>Methods:</i> Thirty-seven participants between the ages of 18-20 (72% female; 16% Asian, 3% Native American, 11% Black or African American, 59% White; 32% Latino/a/x) were recruited via social media advertisement and attended a laboratory visit. The Stop Signal Reaction Time (SSRT) was calculated as the outcome for three experimental blocks and used as indicators in a CFA.<i>Results:</i> CFA suggests the task yields reliable scores; factor loadings were statistically significant (<i>p</i> < .05) and substantial (standardized loadings ranged from .74 to .94). However, reliability increased across experimental blocks and error was non-trivial (ranging from 50% to 12% of the variance). The inhibition factor predicted higher maximum number of drinks consumed (<i>β</i> = .37, <i>p</i> < .05), higher frequency of cannabis use (<i>β</i> = .39, <i>p</i> < .05), and more cannabis use occasions within using days (<i>β</i> = .40, <i>p</i> < .05), as well as facets of mental health (anxious/depression, attention, and anxiety problems; all <i>p's</i> < .05).<i>Conclusion:</i> Results support the utility of CFA to test for reliability of measurement, with the ability to inhibit dominant responses serving as a transdiagnostic correlate of substance use and mental health problems.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"462-470"},"PeriodicalIF":2.7,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of sleep in the link between cannabis use and memory function: evidence from a cross-sectional study.","authors":"T Brown, R A Ackerman, E Kroon, L Kuhns, J Cousijn, F M Filbey","doi":"10.1080/00952990.2024.2362832","DOIUrl":"10.1080/00952990.2024.2362832","url":null,"abstract":"<p><p><i>Background:</i> It is known that cannabis use affects memory and sleep problems independently. However, to date, how memory and sleep problems may interact as a result of cannabis use remains unknown.<i>Objectives:</i> We performed a secondary analysis of existing data to determine whether sleep quality mediates the association between cannabis use and memory and whether sex moderated these effects.<i>Methods:</i> A total of 141 adults with cannabis use disorder (CUD) (83 men) and 87 without CUD (39 men) participated in this study. Outcome measures included self-reported sleep problems from the past 7 days (Marijuana Withdrawal Checklist), learning and memory performance via the short visual object learning task (sVOLT), short visual object learning task delayed (sVOLTd), and verbal memory via the N-back. Bootstrapped mediation and moderated mediation analyses were run to test if sleep quality mediated the association between cannabis use and memory outcomes and whether sex moderated these effects, respectively.<i>Results:</i> Sleep quality mediated the effect of group (i.e. adults with and without CUD) on sVOLT efficiency scores (indirect effect ß = -.08, 95% CI [-0.14, -0.04]) and sVOLTd efficiency scores (indirect effect ß = -.09, 95% CI [-0.14, -0.04]), where greater sleep difficulties was associated with poorer memory performance (decreased efficiency scores). Sex did not moderate these relationships.<i>Conclusion:</i> These initial findings of a mediating role of sleep in the association between CUD and visual learning memory highlight potential critical downstream effects of disrupted sleep in those with CUD and suggest the importance of investigating sleep in CUD.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"547-556"},"PeriodicalIF":2.7,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential effects of moderate chronic ethanol consumption on neurobehavior, white matter glial protein expression, and mTOR pathway signaling with adolescent brain maturation.","authors":"Emine B Yalcin, Ming Tong, Busra Delikkaya, William Pelit, Yiwen Yang, Suzanne M de la Monte","doi":"10.1080/00952990.2024.2355540","DOIUrl":"10.1080/00952990.2024.2355540","url":null,"abstract":"<p><p><i>Background:</i> Adolescent brains are highly vulnerable to heavy alcohol exposure. Increased understanding of how alcohol adversely impacts brain maturation may improve treatment outcomes.<i>Objectives:</i> This study characterizes short-term versus long-term effects of ethanol feeding on behavior, frontal lobe glial proteins, and mTOR signaling.<i>Methods:</i> Adolescent rats (8/group) were fed liquid diets containing 26% or 0% ethanol for 2 or 9 weeks, then subjected to novel object recognition (NOR) and open field (OF) tests. Frontal lobes were used for molecular assays.<i>Results:</i> Significant ethanol effects on OF performance occurred in the 2-week model (<i>p</i> < .0001). Further shifts in OF and NOR performance were unrelated to ethanol exposure in the 9-week models (<i>p</i> < .05 to <i>p</i> < .0001). Ethanol inhibited MAG1 (<i>p</i> < .01) and MBP (<i>p</i> < .0001) after 2 but not 9 weeks. However, both control and ethanol 9-week models had significantly reduced MAG1 (<i>p</i> < .001-0.0001), MBP (<i>p</i> < .0001), PDGFRA (<i>p</i> < .05-0.01), and PLP (<i>p</i> < .001-0.0001) relative to the 2-week models. GFAP was the only glial protein significantly inhibited by ethanol in both 2- (<i>p</i> < .01) and 9-week (<i>p</i> < .05) models. Concerning the mTOR pathway, ethanol reduced IRS-1 (<i>p</i> < .05) and globally inhibited mTOR (<i>p</i> < .01 or <i>p</i> < .001) in the 9- but not the 2-week model.<i>Conclusions:</i> Short-term versus long-term ethanol exposures differentially alter neurobehavioral function, glial protein expression, and signaling through IRS-1 and mTOR, which have known roles in myelination during adolescence. These findings suggest that strategies to prevent chronic alcohol-related brain pathology should consider the increased maturation-related vulnerability of adolescent brains.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"492-516"},"PeriodicalIF":2.7,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11824867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness of the potential consequences of alcohol consumption in the context of chronic pain and prescription opioid use.","authors":"Emma C Lape, Michael B Paladino, Jessica M Powers, Lisa R LaRowe, Joseph W Ditre","doi":"10.1080/00952990.2024.2375515","DOIUrl":"10.1080/00952990.2024.2375515","url":null,"abstract":"<p><p><i>Background:</i> Alcohol and prescription opioid use are highly prevalent among chronic pain populations. One-fifth of individuals prescribed opioids report same-day use of alcohol and opioids. Alcohol use and alcohol/opioid co-use can have deleterious pain management and health outcomes. The extent to which individuals with chronic pain are aware of these deleterious outcomes is considerably understudied.<i>Objectives:</i> To explore individuals' understanding of seven health- and pain-related risks of alcohol/alcohol-opioid use. An exploratory aim was to examine whether greater risk awareness was associated with alcohol/opioid use patterns.<i>Methods:</i> Participants included 261 adults age ≥21(36.4% women) endorsing current alcohol use, chronic musculoskeletal pain, and opioid prescription who completed an online survey via Amazon Mechanical Turk.<i>Results:</i> Distribution of the total number of items for which a participant endorsed awareness was as follows: zero (10.7%), one (5.0%), two (13.0%), three (13.8%), four (13.8%), five (11.5%), six (10.0%), and seven items (22.2%). Awareness of the health consequences of alcohol/alcohol-opioid use was positively associated with opioid misuse behaviors (β = .525, ΔR² = .251, <i>p</i> < .001), and higher-risk alcohol consumption (β = .152, ΔR² = .021, <i>p</i> = .011).<i>Conclusion:</i> Many adults with chronic pain are unaware of the health consequences of alcohol/alcohol-opioid use. Findings of positive covariation between risk awareness and higher-risk alcohol/opioid use suggest that future interventions among this population should go beyond simple risk education and utilize motivational enhancement to help change decisional balance.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"517-524"},"PeriodicalIF":2.7,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11591990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anger is more strongly associated with alcohol and tobacco use and use disorders compared to other substances in American adults.","authors":"Krista Miloslavich, Margaret Wardle","doi":"10.1080/00952990.2024.2331721","DOIUrl":"10.1080/00952990.2024.2331721","url":null,"abstract":"<p><p><i>Background:</i> Anger is elevated in substance use disorders (SUDs) and related to problematic use. However, it is unclear whether anger is elevated in individuals who use substances, is only heightened among those with SUDs, and whether anger is more strongly tied to use of certain substances or SUDs.<i>Objectives:</i> We examine the association between anger, general substance use and SUDs.<i>Methods:</i> Data is <i>N</i> = 28,753 (55% female) respondents from the NESARC-III. Participants endorsing anger and indicating negative functional impact were deemed to have experienced significant anger.<i>Results:</i> Logistic regression examining the relative strength of associations between anger, substance use and SUDs (alcohol, opioid, stimulant, tobacco and cannabis) indicated that having a SUD was associated with anger beyond use alone. Alcohol (adjusted odds ratio [AOR] = 1.45; 95% CI 1.32-1.6) and tobacco (AOR = 1.38; 95% CI 1.27-1.51) use displayed the strongest odds of experiencing anger above and beyond other substances in the model. Similarly, alcohol (AOR = 1.45; 95% CI 1.31-1.62) and tobacco (AOR = 1.46; 95% CI 1.3-1.64]) use disorders had the greatest odds of anger relative to other SUDs. These results were significant after controlling for mood, anxiety disorders, and PTSD and no sex differences were observed.<i>Conclusion:</i> These results indicate that SUDs, particularly alcohol and tobacco use and disorders, are positively associated with experiencing anger beyond just substance use. Research must identify the mechanism driving this association to enhance treatments that target anger.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"433-441"},"PeriodicalIF":2.7,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alterations in self-reported sensory gating and interoception in individuals frequently using cannabis.","authors":"Bess F Bloomer, Eric R Larson, Rachel L Tullar, Emma N Herms, Amanda R Bolbecker, Brian F O'Donnell, William P Hetrick, Krista M Wisner","doi":"10.1080/00952990.2024.2332602","DOIUrl":"10.1080/00952990.2024.2332602","url":null,"abstract":"<p><p><i>Background:</i> Cannabis use is associated with altered processing of external (exteroceptive) and internal (interoceptive) sensory stimuli. However, little research exists on whether subjective experiences of these processes are altered in people who frequently use cannabis. Altered exteroception may influence externally oriented attention, whereas interoceptive differences have implications for intoxication, craving, and withdrawal states.<i>Objectives:</i> The goal of the current study was to investigate subjective experiences of exteroceptive sensory gating and interoception in people frequently using cannabis. We hypothesized subjective impairments in sensory gating and elevations in affect-related interoceptive awareness; furthermore, such deviations would relate to cannabis use patterns.<i>Methods:</i> This cross-sectional study of community adults 18-40 years old included 72 individuals (50% female) who used cannabis at least twice a week (not intoxicated during study) and 78 individuals who did not use cannabis (60% female). Participants completed the Sensory Gating Inventory and the Multidimensional Assessment of Interoceptive Awareness-2 surveys. People using cannabis completed surveys on cannabis use patterns. Analyses tested group differences and associations with cannabis use.<i>Results:</i> People using cannabis reported impaired sensory gating (<i>d</i> = 0.37-0.44; all <i>p</i> values < 0.05) and elevations of interoceptive awareness related to detection and affect (<i>d</i> = 0.21-0.61; all <i>p</i> values < 0.05). Problematic cannabis use was associated with increased sensory gating impairments (<i>r</i> = 0.37, <i>p</i> < .05). Interoceptive awareness was unrelated to cannabis use variables.<i>Conclusion:</i> These findings extend literature on subjective experiences of sensory processing in people using cannabis. Findings may inform inclusion of external attentional tendencies and internal bodily awareness in assessments of risk and novel treatment approaches.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"525-535"},"PeriodicalIF":2.7,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A national longitudinal study of sexual orientation discordance, sexual identity fluidity, and alcohol and other drug use disorder symptoms.","authors":"Sean Esteban McCabe, Kara Dickinson, Curtiss W Engstrom, Luisa Kcomt, Philip T Veliz, Carol J Boyd, Luis A Parra, Rebecca Evans-Polce","doi":"10.1080/00952990.2024.2378837","DOIUrl":"10.1080/00952990.2024.2378837","url":null,"abstract":"<p><p><i>Background:</i> Many national studies fail to account for discordance between sexual orientation dimensions (e.g. a mismatch between sexual identity and sexual attraction) or sexual identity fluidity (e.g. changes in sexual identity over time).<i>Objective:</i> To examine the longitudinal relationships among sexual identity fluidity/stability, sexual orientation discordance/concordance, and alcohol and other drug use disorder symptoms.<i>Methods:</i> The study used nationally representative longitudinal data from Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health (PATH) study of US adolescents and adults (<i>N</i> = 24,591).<i>Results:</i> Substance use disorder symptoms were most prevalent (45.8%) among bisexual-stable females relative to all other sexual identity subgroups. The adjusted odds ratios (AORs) of substance use disorder symptoms were significantly higher among bisexual-stable females vs. heterosexual-stable females in all models (AOR range: 1.94-2.32), while no such associations were found for males. Sexual identity-attraction discordant females had significantly greater AORs (17/20 instances) of substance use disorder symptoms compared to concordant females; this finding was not as consistent for males (6/20 instances).<i>Conclusion:</i> Sexual orientation discordance was significantly associated with substance use disorder symptoms, especially among females discordant in their sexual identity and attraction. Bisexual-stable and discordant females are at highest risk of developing symptomatic substance use; it is vital that they receive screening, no matter where they are in their coming out process. This study highlights pitfalls of relying solely on cross-sectional data using a single sexual orientation dimension to understand the relationship between sexual orientation and substance use disorder.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"481-491"},"PeriodicalIF":2.7,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of psychosocial interventions for alcohol use disorder: a systematic review and meta-analysis update.","authors":"Abhishek Ghosh, Nirvana Morgan, Tanya Calvey, Florian Scheibein, Ioannis Angelakis, Maria Panagioti, Marica Ferri, Dzmitry Krupchanka","doi":"10.1080/00952990.2024.2350056","DOIUrl":"10.1080/00952990.2024.2350056","url":null,"abstract":"<p><p><i>Background:</i> Given the accumulating research, evolving psychosocial treatment, and equivocal findings, updating WHO's Mental Health Gap Action Programme-2015 was necessary to ensure guidelines reflect effective strategies for alcohol use disorder (AUD).<i>Objective:</i> To estimate the effects of psychosocial interventions on drinking and related outcomes.<i>Methods:</i> We included randomized controlled trials published between January 2015 and June 2022 on adults with alcohol dependence (ICD 10/DSM-IV) and moderate to severe AUD (DSM-5), and those examined psychosocial interventions against treatment-as-usual (TAU) and active controls. Eight databases and registries were searched. Relative Risk (RR) and standardized mean difference (SMD) were used for dichotomous and continuous outcomes. We used Cochrane's risk of bias assessment (RoB2).<i>Results:</i> Of 873 screened records, 14 and 13 studies in the narrative synthesis and meta-analysis. Of the 2,575 participants, 71.5% were men. Thirteen studies used ICD 10/DSM IV diagnosis. Compared to TAU, any psychosocial intervention increased the relative risk of abstinence by 28% [<i>N</i> = 7, RR = 1.28, 95% CI: 1.07 to 1.53, <i>p</i> = .01, NNT = 9]. There were minimal heterogeneity and no evidence of publication bias. Psychosocial interventions were not effective in reducing the drinking frequency (<i>n</i> = 2, Hedge's g = -0.10, 95% CI: -0.46 to 0.26, <i>p</i> = .57) and drinks/drinking days (<i>N</i> = 5, g = -0.10, 95% CI: -0.37 to 0.16, <i>p</i> = .43). Treatment discontinuation did not differ between intervention and control groups [RR = 1.09, 95% CI: 0.66 to 1.80].<i>Conclusion:</i> Psychosocial interventions are effective in improving abstinence but not in reducing drinking frequency or amount. Policymakers must consider this evidence to generate AUD treatment guidelines.<i>Registration:</i> PROSPERO 2022 CRD42022342608.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"442-454"},"PeriodicalIF":2.7,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}